Abstract
Only a few reports have examined vascular endothelial function before and after educational hospitalization and the factors that affect it in patients with type 2 diabetes mellitus (T2DM). The aim of this study was to assess vascular endothelial function before and after educational hospitalization and identify factors that affect it. In 65 patients with T2DM who underwent peripheral arterial tonometry (EndoPAT) before and after hospitalization, vascular endothelial function (reactive hyperemia index [RHI]), glucose metabolism, lipid metabolism, and blood pressure were assessed before and after hospitalization. The primary endpoint was hospitalization-induced changes in vascular endothelial function. Educational hospitalization significantly improved the natural logarithmically scaled RHI (L_RHI) from 0.555 ± 0.212 to 0.625 ± 0.245 (p = 0.012). Multivariable logistic regression analysis identified hypoglycemia during hospitalization as the single factor that significantly altered vascular endothelial function (p = 0.019). The odds of achieving normal vascular endothelial function were 0.08 times lower (95% confidence interval, 0.01–0.67) for each episode of hypoglycemia. Furthermore, multivariable analysis identified hypoglycemia during hospitalization as the single factor that worsened L_RHI. Our study showed that educational hospitalization of patients with T2DM improved vascular endothelial function, and that the development of hypoglycemic episodes had a significant negative impact on normalization of vascular endothelial function.
Highlights
A few reports have examined vascular endothelial function before and after educational hospitalization and the factors that affect it in patients with type 2 diabetes mellitus (T2DM)
A comparison of patients with normal vascular endothelial function and those with vascular endothelial dysfunction on admission is presented in Supplemental Table 1
Our group has reported that fluctuations in blood glucose levels, postprandial hyperglycemia, and hypoglycemia are associated with vascular endothelial dysfunction in diabetic patients[4]
Summary
A few reports have examined vascular endothelial function before and after educational hospitalization and the factors that affect it in patients with type 2 diabetes mellitus (T2DM). The aim of this study was to assess vascular endothelial function before and after educational hospitalization and identify factors that affect it. Improvement of various metabolic abnormalities may subsequently improve vascular endothelial function; little is known about the outcome of in-patient diabetes education, especially with regard to vascular endothelial dysfunction. It is not clear which factor(s) related to vascular endothelial function are affected by such programs. The present study was designed to document the changes in endothelial function in T2DM patients after receiving in-patient diabetes education and the variables associated with these changes
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